Job Description
DESCRIPTION
We are seeking an experienced Clinical Quality Manager for Senior Health to join Amazon One Medical. Reporting directly to the National Leader for Clinical Quality, this role will be responsible for clinical quality performance for One Medical Seniors throughout the country, focusing on Medicare Advantage Stars and ACO REACH programs, driving excellence in healthcare outcomes through data-driven strategies and team leadership.
Key job responsibilities
Quality Strategy & Program Leadership:
- Lead initiatives to improve the quality of care delivered for Senior Health, as measured by HEDIS, Medicare Advantage Stars, ACO REACH, and other national quality metrics.
- Design and implement national quality improvement strategies that enhance health outcomes, patient satisfaction, and performance on value-based care contracts.
- Guide cross-functional teams in the execution of quality collaboratives and improvement initiatives in partnership with senior leaders.
Performance Monitoring & Reporting
- Monitor, analyze, and interpret quality performance metrics to generate actionable insights and drive continuous improvement.
- Develop and maintain dashboards, and reporting systems that track performance across key clinical and operational measures.
- Participate in weekly and monthly business reviews related to quality and Senior Health program performance; contribute to other business reviews as needed.
Stakeholder Collaboration & Communication
- Partner closely with clinical and operational stakeholders to drive alignment and achieve quality goals.
- Collaborate with internal teams across clinical operations, analytics, product, and finance to ensure integrated, data-driven decision-making.
- Work with product teams to translate quality priorities into system configurations, workflows, and reporting tools.
Payor & External Engagement
- Serve as a key liaison with payer partners; lead discussions to ensure performance meets contractual quality and regulatory requirements.
- Represent One Medical in payer Quality Committees; support payer-facing medical leaders with preparation and strategy to achieve shared goals.
- Regularly engage with payer and internal quality leaders to align on core quality measures and develop workflows to support measurement and improvement.
Regulatory Compliance & Vendor Management
- Ensure full compliance with CMS regulations, quality reporting standards, and related documentation requirements.
- Manage performance on Value-Based Contracts and ACO programs, including oversight of related vendor relationships that support measurement and patient outreach.
About the team
You’ll work closely with a matrixed group of stakeholders and will directly lead a team of coordinators to support the work. Your role will involve working with peers and leaders across the business to support the Seniors team’s goals and the overall quality objectives for Amazon One Medical. You’ll thrive here if you’re passionate about supporting patients, driving outcomes, and bringing energy and creativity to a challenging but rewarding environment.
BASIC QUALIFICATIONS
- 5+ years of working cross functionally with tech and non-tech teams experience
- 5+ years of team management experience
- 5+ years of cross functional project delivery experience
- 5+ years of program or project management experience
- Experience defining program requirements and using data and metrics to determine improvements
- 10+ years progressive professional experience in healthcare
- 5+ years in quality improvement and experience working with payers and healthcare organizations, Medicare Advantage Stars and/or ACO quality programs
- 3+ years experience in leading, managing and developing QI teams
- Strong understanding of CMS and HEDIS quality measures and reporting requirements
Job Tags
Full time,